Perceptions of involvement in advance care planning and emotional functioning in patients with advanced cancer

L.L. Kroon, J. van Roij, I.J. Korfage, A.K.L. Reyners, M.H.J. Van den Beuken-van Everdingen, M.O. den Boer, G.J. Creemers, A. de Graeff, M.P. Hendiks, J.C.B. Hunting, W.K. de Jong, E.J.M. Kuip, H.W.M. van Laarhoven, L. van Leeuwen, A.S.R. van Lindert, C.M.P.W. Mandigers, P. Nieboer, A. Van der Padt-Pruijsten, T.J. Smilde, D.W. SommeijerM.F. Thijs, M.A. Tiemessen, A.H. Vos, A. Vreugdenhil, P.T. Werner, L. van Zuylen, L.V. Van de Poll-Franse, N.J.H. Raijmakers*, eQuiPe study group

*Corresponding author for this work

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Purpose Advance Care Planning (ACP) is positively associated with the quality of care, but its impact on emotional functioning is ambiguous. This study investigated the association between perceptions of ACP involvement and emotional functioning in patients with advanced cancer. Methods This study analyzed baseline data of 1,001 patients of the eQuiPe study, a prospective, longitudinal, multicenter, observational study on quality of care and quality of life in patients with advanced cancer in the Netherlands. Patients with metastatic solid cancer were asked to participate between November 2017 and January 2020. Patients' perceptions of ACP involvement were measured by three self-administered statements. Emotional functioning was measured by the EORTC-QLQ-C30. A linear multivariable regression analysis was performed while taking gender, age, migrant background, education, marital status, and symptom burden into account. Results The majority of patients (87%) reported that they were as much involved as they wanted to be in decisions about their future medical treatment and care. Most patients felt that their relatives (81%) and physicians (75%) were familiar with their preferences for future medical treatment and care. A positive association was found between patients' perceptions of ACP involvement and their emotional functioning (b=0.162, p, 95%CI[0.095;0.229]) while controlling for relevant confounders. Conclusions Perceptions of involvement in ACP are positively associated with emotional functioning in patients with advanced cancer. Future studies are needed to further investigate the effect of ACP on emotional functioning. Implications for Cancer Survivors Patients' emotional functioning might improve from routine discussions regarding goals of future care. Therefore, integration of ACP into palliative might be promising.
Original languageEnglish
Pages (from-to)380-385
Number of pages6
JournalJournal of Cancer Survivorship-Research and Practice
Issue number3
Publication statusPublished - 1 Jun 2021


  • Advance care planning
  • Quality of life
  • Advanced cancer
  • Palliative care

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